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In this qualitative inquiry, we set out to explore the experience of condom use and erectile disorder (ED) among men living with HIV in a rural district of Zimbabwe. Data on condom use related erectile disorder with antiretroviral (ART) medication were collected from a purposive sample of 18 men living with HIV and AIDS (age range 23–54 years). These data were supplemented with those from a convenience sample of 23 women living with HIV who self-identified as partners of men living with HIV and AIDS (age range 26–37 years). The data were thematically analyzed. Results suggest that men attributed their experiencing of erectile problems to two main explanations: use of condoms and ART medication. These men reported inconsistent use of condoms and/or adherance to ART therapy due to a belief that these cause their ED. The women informants reported similar observations, including the shared gendered perspective that the men perceived a loss of sense of manhood from ED. Beliefs that influence health promotion w...

Venoocclusive disorder, also known as venous leak and anticipatory anxiety, are both common causes of erectile disorder. The clinical presentation and investigations using ultrasonography have some common findings during the preliminary assessment process. We present a treatment approach which may be offered in both conditions and which may require reduced doses or eventually allow withdrawal off medication. The Sheffield PDE5i and Ring Duo Technique uses maximum tolerated doses of sildenafil, tadalafil or vardenafil alongside penoscrotal rings to secure reliable and cosmetically aesthetic erections.

Can perfectionism contribute to marital and sexual dysfunction? The examination of a range of variables that may have an effect between degrees of perfectionism in a man or his partner and marital satisfaction and sexual functioning is reported (MARTEN DI BARTOLO, P. & BARLOW, D.H. (1996) Perfectionism, marital satisfaction and contributing factors to sexual dysfunction in men with erectile disorder and their spouses, Archives of Sexual Behavior, 25, pp. 581-588). Perfectionism was measured using the Multidimensional Perfectionism Scale (MPS) and measure of marital satisfaction by the Dyadic Adjustment Scale (DAS). Rating scores of organicity and psychogenicity contribution towards erectile dysfunction using various criteria and different clinicians for each rating were obtained. Higher overall levels of perfectionism were found to be associated with high clinician ratings with regard to the influence of psychogenic variables in contributing to dysfunctional men's erectile difficulties. Neither d...

Intracavernosal injection therapy is now extensively used in the treatment of erectile disorder. It is effective in promoting erectile function in at least 80% of unselected patients. Overall, there is an extensive literature on this approach to treatment but the majority of papers relate to pharmacological, urologic or mechanistic issues. Reported studies that include psychological and behavioural aspects are scattered thinly throughout the literature. This paper attempts to review these aspects of intracavernosal injection therapy and emphasizes the desirability of the combined sex therapy-intracavernosal injection approach to the management of erectile disorder.

The fundamental need for psychodynamic clinical interventions in most cases of sexual dysfunction has never been denied. Equally, specific clinical interventions of a physiodynamic nature are a fundamental part of the richness of treatment resources in most cases of erectile dysfunction. In recent years, in the presence of uncertainties about the long-lasting therapeutic effects of exclusive methodology, advocacy for a professional approach in favour of the use of integrative systems in the treatment of sexual dysfunction has been strong. The practitioner of sexual and relationship psychotherapy, whatever his or her base discipline, is required in the name of therapeutic effectiveness to consider the psychological and the organic when establishing a plan of treatment. This is particularly true in the case of male erectile dysfunction, the most common of all sexual arousal disorders. This paper considers the role of Vacuum Constriction Devices (VCDs) in terms of their biopsychosocial cause and eff...

We provide a comprehensive review of the empirical literature regarding the prevalence of erectile disorder among men with diabetes mellitus. Estimates have varied from 7–85%, depending on sample c...

This paper explores the range of psychosexual problems identified in people with HIV infection and AIDS. It includes problems related to sexuality or the need to discuss sexuality with others. Erectile disorder and reduced sexual drive are sometimes presented. Many individuals experience sexual relationship difficulties generally and specific problems associated with the adoption and maintenance of safer sexual behaviours. Such maintenance is a long-term problem. Discussion surrounding procreation is relevant for all clients, irrespective of their sexuality. Other sexually transmitted diseases may facilitate transmission and disease progression and hence enter the HIV arena. Lastly, sex for money, and rape are discussed. An intervention study is briefly described in an attempt to quantify the range and extent of psychosexual problems arising during counselling and the efficacy of counselling training in these skills for non-mental health staff working with AIDS and HIV positive clients. Short tra...

Sociocultural influence on sexual behavior is beyond doubt. It is difficult to attribute the wide range of different sexual behaviors in different societies to constitutional predisposition only. This study represents an open longitudinal prospective to collect sociodemographics as well as relevant medical data from all patients, attending a psychiatric clinic in a general psychiatric hospital, complaining of psychogenic sexual dysfunctions in a period of one year. Patients were selected only if organic causes for their dysfunctions were excluded and positive psychogenic factors were identified. A total of 38 male and 5 female patients were seen during this period. Twenty-five males had erectile disorder and the remaining 13 had premature ejaculation. Among the females, 2 had vaginismus and 3 had dyspareunia. Eighty-eight percent of the male patients were younger than 40 years and married for less than 5 years. The premature ejaculators were relatively older than the impotents (85% older than 40 years). T...

Increasing therapeutic options available for the treatment of erectile disorder and the earlier identification of the problem in elderly patients has led to an increase in demand for treatment. While a decline in sexual function and desire can be expected with increasing age, little information exists on normal levels of sexual activity in the UK in the elderly male patient. One hundred consecutive unselected urological patients over 60 awaiting urlogical surgery were interviewed in detail to determine their sexual function. Results show an average age of 70 with 35% having had sex within the past year. Fifty-four percent of patients aged between 60 and 69 who had partners had had sex within the last two months. Twenty-nine percent had complete erectile failure while 9% were dissatisfied with their sex lives. We have shown that while sexual function decreases with age a significant percentage of patients over 60 remain sexually active. Although the vast majority are happy with their sex lives 9% ...

Erection obtained with a vacuum pump can be a solution for the impotent man. In this study it was proposed to and discussed with couples, eleven of whom chose it as treatment. The mean age of the men was 54 years and 8 months. The estimated etiology of their erectile disorder was: biogenic, 4, mixed, 7. A 25-item questionnaire was administered to each couple. Results show that the device was a good solution and improved the sex life of both partners. They manifested a fair degree of satisfaction with its use. The presence and the participation of the female partner should be considered in therapeutic recommendations for erectile disorders.

Sex therapy in China has developed over the past three years, despite being largely unknown by the public and many clinical practitioners. This paper describes a short-term, comprehensive sex therapy, employing cognitive-behavioural techniques which were used to treat 21 couples with erectile dysfunction, where the remission rate was 61.8%. The authors believe that the technique of couple evaluation proved to be an objective measure of change. There was a close relationship between the outcome of therapy and the following factors: the course of therapy, the wife's attitude to sex, the level of the patients' psychosocial problems, and the state of the marriage itself.

The purpose of this study was to develop and validate the Sexual Self-Efficacy Scale (SSES-E) for erectile disorder. The subjects consisted of 15 heterosexual couples with nonproblematic sexual functioning (normal group) and a sexually dysfunctional sample consisting of nine heterosexual couples and eight heterosexual single males (dysfunctional group). Most of the males in the dysfunctional sample were diagnosed as suffering from erectile disorder. Reliability of the SSES-E, based on test-retest and split-half correlations and on item analyses, appears to be reasonable. Validity, measured in three different ways, is also acceptably high. Suggestions for the use of this instrument in clinical practice and for future research are made.